Naloxone Administration Training Registration

Naloxone Administration Submission Form

Naloxone is a life-saving medication that can reverse an overdose from opioids鈥攊ncluding heroin, fentanyl, and prescription opioid medications. Health, Outreach, Prevention and Education (HOPE) Services presents DCCCA's one-hour naloxone administration course to the 黑洞社区 community to equip participants with the knowledge and skills necessary to identify and respond to an overdose crisis using naloxone and other available resources. Course content is provided by DCCCA, a nonprofit organization with the mission to provide social and community services that improve the safety, health and well-being of individuals in Kansas and Oklahoma.

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Full Name:*

Email Address:*

What is your major or field of study?

Are you currently enrolled as a graduate student?

Are you a member of a student or Greek organization?*

If yes, which one?

Are you a student employee?*

If yes, which department?

Which session do you wish to attend?*

Student ID: